目的 分析子宫内膜增生合并子宫腔粘连患者的一般情况、临床特点、治疗及转归。方法 选择2018-01至2023-07首都医科大学附属北京天坛医院行宫腔镜检查后发现子宫内膜增生合并子宫腔粘连的患者12例,对其临床特点,病史、超声和病理结果、转归进行回顾性分析。结果 12例患者宫腔镜下所见为子宫腔粘连样改变,病理结果为子宫内膜增生。术前超声提示子宫内膜增厚,回声不均匀,合并月经紊乱病史或糖尿病病史的患者需警惕子宫内膜非典型增生。后续遵照子宫内膜病理进行治疗。结论 子宫腔粘连可能与子宫内膜增生同时存在,应避免无内膜病理情况下使用雌激素治疗;宫腔镜手术前需要根据患者高危因素及超声进行评估,术中应注意子宫内膜异常形态以及子宫内膜的采集。
Abstract
Objective To investigate the demographic data, clinical characteristics ,treatment and prognosis of endometrial hyperplasia with intrauterine adhesions.Methods Patients who underwent hysteroscopy for endometrial hyperplasia due to intrauterine adhesions in Beijing Tiantan Hospital from January 2018 to July 2023 were enrolled. Their medical history, clinical characteristics, and the prognosis of the cohort were analyzed retrospectively.Results Among the 12 eligible cases, hysteroscopic changes were observed as intrauterine adhesion-like changes. The pathological results showed endometrial hyperplasia. The risk factors of endometrial atypical hyperplasia are endometrium thickening, endometrial echo inhomogeneous, diabetes, menstrual disorders. The following treatments were determined according to the pathological results.Conclusions Trans-vaginal ultrasound and risk factors should be taken into considered. Attention should be paid to the abnormal morphology of endometrium during the operation. Intrauterine adhesions can coexist with endometrial hyperplasia, so estrogen treatment should be avoided before diagnosis.
关键词
子宫腔粘连 /
子宫内膜增生 /
经阴道超声 /
宫腔镜
Key words
intrauterine adhesions /
endometrial hyperplasia /
trans-vaginal ultrasound /
hysteroscopy
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参考文献
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